A Geospatial Analysis of Health, Mental Health, and Stressful Community Contexts in Los Angeles County

Abstract

IntroductionDespite numerous federal investments, chronic disease continues to disproportionately affect certain communities across the United States. Understanding the regional distribution (including any overlaps) of factors that extend beyond built and food environments, especially factors that may adversely affect chronic disease–related behaviors, is important. This case study of Los Angeles County’s geospatial landscape sought to address these gaps in research and practice.MethodsWe examined the distributions and geographic overlaps between economic hardship, psychological distress, soda consumption, and availability of publicly funded mental health facilities in 8 Service Planning Areas in Los Angeles County. We categorized the geospatial presence of each variable as low, intermediate, or high. We imported all data, collected during 2014–2018, into ArcGIS Pro version 2.3.3 to create 5 bivariate choropleth maps.ResultsLevels of economic hardship were not equally distributed across communities; the county was characterized by intermediate levels of soda consumption and psychological distress. Most areas had low or intermediate availability of publicly funded mental health facilities. We also found some discordance between psychological distress and availability of publicly funded mental health facilities, and between economic hardship and availability of these facilities.ConclusionThe need exists to address disparities in economic hardship and to increase access to publicly funded mental health supports and providers in Los Angeles County. The information collected in this case study has policy implications for health, public health, and mental health services planning at the local level.

What Are the Relationships between Psychosocial Community Characteristics and Dietary Behaviors in a Racially/Ethnically Diverse Urban Population in Los Angeles County?

“…In the descriptive analyses, soda consumption scores were categorically measured: (0) optimal consumption (0 sodas per week); (1) intermediate consumption (1–6 sodas per week); or (2) worse consumption (7 or more sodas per week). These categories are consistent with those employed by other studies in LAC [ 38 , 47 ]. Like daily F+V consumption, soda consumption was analyzed as a count in the regression analyses.…”

“…This sociodemographic information was used to determine and apply quota targets to the sample so that they aligned with the 2010 U.S. Census estimates for adults in the region (i.e., the firm sampled from eligible survey panel subscribers until saturation was reached for the sex, age, race/ethnicity, income, and education level stratum). This application of U.S. Census-based quota criteria has been previously employed in similar surveys as a way to improve a sample’s representativeness of the LAC population [ 38 , 39 ].…”

“…With a total of 1000 subscribers (participants) who completed the survey, the participation rate was estimated to be about 33%. Survey methods and protocols, including the application of target quotas, have been described in more detail elsewhere [ 38 , 39 ].…”

“…Weekly soda consumption was assessed by asking participants the following question used in prior DPH studies [ 38 , 45 ]: “In an average week, about how many regular sodas such as Coke or Mountain Dew, do you drink? Do not include diet sodas or sugar-free drinks.…”

“…Scores ranged from 13.2 to 82.5, with higher values indicating greater community-level economic hardship. Prior studies using the same dataset as in the present study described how the community-level economic hardship variable was constructed [ 38 , 39 ].…”